When it comes to the topic of senior care, no one wants to think about the sad reality that elder abuse can, and sometimes does, happen in the home care setting. While elder abuse is a complicated matter, there are things we can do as caregivers to spot the more common risk factors and protect vulnerable seniors from abuse.
To understand how to assess the risk and prevent elder abuse, it is helpful to first understand the problem more fully. While there are many variations, elder abuse can be divided into seven categories.
Physical Abuse - When the word abuse is mentioned, this is what most people think of. Examples include, but aren't limited to, hitting, biting, kicking, scratching, and leaving bruises.
Exploitation - A common form of exploitation is using an elderly individual for money or other assets. In the home caregiving environment, this is often a family member collecting a pension or social security check without using the funds for the senior's needs.
Abandonment - The act of not providing care to an individual who has been placed in one's charge.
Neglect - The act of not providing for the individual’s needs such as food, shelter, water or medications.
Sexual Abuse - Unwanted or non-consensual sexual activity.
Emotional Abuse - Threats or name calling are common for this type of abuse. In the home care environment, you might see someone threaten a senior with being put in a nursing home for not taking their medications or saying hurtful things about their disabilities.
Self-Neglect - When an individual is able but unwilling to take care of their own personal needs, including health and safety concerns. A good example is the individual who refuses to take their necessary medications because it is costing them too much money.
Elder abuse is a crime in all fifty U.S. states and, while the laws of each state have minor variances, they tend to adhere to the federal standard in the area of senior abuse. The Center For Disease Control (CDC) provides a loose definition of the term as “an intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult. ”
With that broad definition, it is easy to see that elder abuse is a very serious concern that can easily become a murky legal area for caregivers, as the CDC points out with their statement that "elder abuse has been 1) poorly or imprecisely defined, 2) defined specifically to reflect the unique statutes or conditions present in specific locations (e.g., states, counties, or cities), or 3) defined specifically for research purposes. As a result, a set of universally accepted definitions does not exist".
Risk Factors for Elder Abuse
There are eight primary risk factors that often contribute to senior abuse in the home caregiving environment.
Not using a home caregiver from a reputable home care agency - Unfortunately, not all caregivers are meant for caregiving and some commit elder abuse. This is why it is important to hire caregivers that have been trained and screened by a reputable home care agency.
Being female - Sadly, women are the most likely to be targeted by abusers in the senior care environment. Even worse, it is estimated that only 1 in 14 of all adult abuse cases is reported to authorities.
Over the age of 80 years - Advanced age with declines in health and abilities often leaves individuals more prone to abuse.
Language barriers - Due to lost speech faculties or language differences, seniors with language barriers are more likely to be targeted by abusers since they are unable to properly express themselves and ask for help.
Isolation - As with other abuse crimes, perpetrators of senior abuse often choose isolated victims who lack a strong support system and are often confined to an area where they have limited interactions with the outside world.
Having combative behaviors - These behaviors in a senior can often lead to feelings of frustration for their caregivers. In some cases, this turns into abuse reactions from the caregiver, sometimes with the abuser not even understanding that they are being abusive. For example, an elderly male client might be combative with his wife while she is trying to get him to take his medicine. If his wife slaps him, she is then guilty of physical abuse.
Bad past relationships - With 60% of senior abuse cases being perpetrated by family members, senior abuse is often rooted in a past grudge. For example, it may be a grown child of a senior who felt they were abused during childhood and now finds the opportunity for revenge.
Cognitive impairment - An individual with cognitive difficulties may not understand that they are being abused or how to ask for help.
While some of these risk factors, such as gender, age, and cognitive function, are beyond the control of a home caregiver or family member of a senior who requires care, all of the risks can be mitigated by the use of proper care and procedure in the home caregiving environment.
For families, choosing an appropriate and reputable home caregiving agency can go a long way in deterring possible senior abuse and neglect. Reputable agencies thoroughly screen prospective employees during the hiring process and afterwards require that they maintain a high level of professionalism throughout their employment. By working closely with the home caregiving agency and providing feedback about their team members, family members can assist caregivers in providing suitable senior care for loved ones and eliminate much of the risk of elder abuse.
For professional home caregivers, maintaining contact with their home care agency’s leadership and keeping themselves alert to changes in their client's health, demeanor, and abilities is vital to protecting seniors from abuse. As a caregiver, you must understand each of the different forms of abuse and how they relate to your clients. This is especially important when we realize that 60% of abusers are adult children or spouses of their victims which means that we are likely to be our clients first line of defense against abusive activities within their home.
If you are looking for a home caregiver from a reputable agency, or if you would like to work for a reputable home care agency, please contact us at Alegre Health Care.